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Updated: May 5, 2025
The nerves are diffusely and unequally thickened, so that small twigs may become enlarged to the size of the median, while at irregular intervals along their course the connective-tissue overgrowth is exaggerated so as to form tumour-like swellings similar to the trunk-neuroma already described.
The connective-tissue framework of a nerve-trunk consists of the perineurium, or general sheath, which surrounds all the bundles; the epineurium, surrounding individual groups of bundles; and the endoneurium, a delicate connective tissue separating the individual nerve fibres. The blood vessels and lymphatics run in these connective-tissue sheaths.
The derma is composed of some muscular fibres interwoven with the connective-tissue fibres. It contains the roots of the hair follicles, sweat and oil glands. The external face which is covered by the epidermis shows a multitude of little elevations. These are the vascular and nervous papillae. In addition, it shows openings through which the hairs and the skin glands pass.
These fibroblasts are large irregular nucleated cells derived mainly from the proliferation of the fixed connective-tissue cells of the part, and to a less extent from the lymphocytes and other mononuclear cells which have migrated from the vessels.
Tendons and blood vessels readily lend themselves to transplantation and will also be referred to later. Muscle and nerve, on the other hand, do not retain their vitality when severed from their surroundings and do not functionate as grafts except for their connective-tissue elements, which it goes without saying are more readily obtainable from other sources.
In some of the cases examined by Dercum he found that the thyroid was indurated and infiltrated by calcareous deposits. The disease is not myxedema because there is no peculiar physiognomy, no spade-like hands nor infiltrated skin, no alteration of the speech, etc. Dercum considers it a connective-tissue dystrophy a fatty metamorphosis of various stages, possibly a neuritis.
The coral polyp saturates itself with the lime-salts of the sea-water, much as the bone-corpuscles with those of the blood and lymph, and thus protects itself in life and becomes the flying buttress of a continent in death. In the familiar connective-tissue, or "binding-stuff," we find a process similar in kind but differing in the degree, so to speak, of its degradation.
In consistence they are firm and elastic, or fluctuating, and are incorporated with the overlying skin, but movable on the deeper structures. The orifice of the partly blocked sebaceous follicle is sometimes visible, and the contents of the cyst can be squeezed through the opening. The wall of the cyst is composed of a connective-tissue capsule lined by stratified squamous epithelium.
Seiffert examined a case of this nature in a young man of nineteen, and, contrary to Kopp's supposition, found that in some skin from over the left second rib the elastic fibers were quite normal, but there was transformation of the connective tissue of the dermis into an unformed tissue like a myxoma, with total disappearance of the connective-tissue bundles.
Various forms of pyogenic infection are met with in muscle, most frequently in relation to pyæmia and to typhoid fever. These may result in overgrowth of the connective-tissue framework of the muscle and degeneration of its fibres, or in suppuration and the formation of one or more abscesses in the muscle substance. Repair may be associated with contracture.
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